In our ongoing efforts to make high-quality and affordable healthcare available to our members, BCBSRI regularly reviews the list of drugs that we cover. Our goal is to make sure that our members continue to have access to effective medications at the lowest possible cost. Changes to the list of drugs requiring prior authorization are made with clinical input from our committee of local, independent doctors and pharmacists. Safety, effectiveness, and cost are all considered before any decisions on changes are made. In addition, prior authorization (PA) helps ensure that drugs are covered, when they are medically necessary.

As a result, effective January 1, 2019, BCBSRI will require PA for Avastin related to oncology-diagnosis that is covered under the medical benefit for Commercial products; this does not include Medicare Advantage products at this time. As with other drugs in the Medical Drug Review program, the PAs will be handled by Prime Therapeutics, LLC, our pharmacy benefits manager. For members currently on this medication, a PA is required; however, continuity of care will be taken into consideration.

For assistance with prior authorizations, please call Prime Therapeutics at 1-844-765-2892. For questions regarding the status of an existing PA, please call BCBSRI’s Provider Services at (401) 274-4848 or 1-800-230-9050.

For other questions, please contact Provider Relations at 1-844-707-5627 or ProviderRelations@bcsri.org.